Diabetes and Hypertension Checklist

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> Diabetes and Hypertension Checklist

Diabetes and Hypertension Checklist

Is there a chance you have, or are at risk for, diabetes or hypertension (high blood pressure)? These are two of the fastest-growing diseases among older adults. If not well managed or left untreated, they can cause serious health complications.

These valuable checklists can help you to connect the dots between your lifestyle and these medical conditions—and have the best possible appointment with your doctor at your next visit. There are many ways to prevent or delay heart disease. The first step is to be screened.

Medicare can help with the costs of screening, diagnosis and treatment. So, please act today.

TAKE-ALONG CHECKLIST:

Please check the boxes next to those Symptoms you are experiencing
Check any risk factors present in your lifestyle or family.
Print or email the completed checklist.

Make an appointment to see your doctor--and take this important checklist along.

DIABETES

POSSIBLE SYMPTOMS

	Increased thirst
	Weight loss in spite of increased appetite
	Nausea
	Blurred vision

	Increased urination
	Fatigue
	Vomiting
	Irritability

HIGH BLOOD PRESSURE (HYPERTENSION)

People with high blood pressure usually do not have any symptoms. Most people with high blood pressure feel fine and only find out they have high blood pressure during a routine exam or a doctor visit for another problem.

Very severe high blood pressure (160 over 100 or higher), especially if your blood pressure rises very high quickly, may lead to hypertensive crisis.

POSSIBLE SYMPTOMS

Symptoms of very severe high blood pressure include:

	Headaches, especially pulsating headaches behind the eyes that occur early in the morning.
	Visual disturbances.

Nausea and vomiting.

Over time, untreated high blood pressure can damage organs, such as the heart, kidneys, or eyes. This may lead to:

	Chest pain (angina), heart attack, or heart failure.
	Stroke.
	Kidney (renal) failure.

	Peripheral arterial disease.
	Eye damage (retinopathy).
	Abnormal heartbeat.

RISK FACTORS FOR DIABETES AND HIGH BLOOD PRESSURE

Please check any that you have.

	Overweight/excess weight
	High blood glucose (sugar)
	High cholesterol (over list number)
	Consistently high blood pressure readings
	Smoking

	Physical inactivity (less than 30 minutes of exercise per day)
	Age ( 65 or older)
	Parent, brother, or sister with diabetes or heart disease
	Waist Circumference - Waist size larger than 35 inches for women and larger than 40 inches for men

Are you a member of one or more of these ethnic groups, or do you have ancestors who were?

	African American
	Latino
	Native American

	Asian American
	Pacific Islander

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